1. Technical Field of the Invention
The present invention relates to medical devices and, in particular, to an Airway Management Apparatus for easing the breathing and aiding the alignment of the oral, pharyngeal, and laryngeal axes of an airway of an obese individual in the supine position.
2. Description of Related Art
Airway management concerns the ability to maintain open air passages in an individual, especially during surgical operations where anesthesia is administered to alter the state of consciousness and stabilize body functions. During such operations, the ability of the body to maintain an adequate airway may be compromised, and external airway management procedures must be undertaken to ensure the breathing airway remains open and unobstructed.
Endotracheal intubation, a medical procedure that secures an individual's airway through placement of a breathing tube in the individual's trachea in order to facilitate either spontaneous or controlled gas exchange, is routinely carried out in operating rooms after the induction of anesthesia or in emergencies to establish and maintain an adequate airway. The endotracheal intubation process requires an unobstructed airway that is obtained by aligning the oral, pharyngeal, and laryngeal axes in the body. This process is usually achieved without great difficulty under direct vision provided by an instrument such as a laryngoscope that exposes the individual's vocal cords.
More specifically, an endotracheal intubation is usually performed using a laryngoscope having a rigid straight blade (known as a Miller type blade), or a rigid curved blade (known as a Macintosh type blade) on a supine and anaesthetized individual. During the endotracheal intubation and prior to the individual being connected to a breathing machine, the individual's breathing is mechanically assisted by a physician or other health professional physically moving air into the individual's lungs with a ventilation bag.
The most commonly used technique in an endotracheal intubation consists of extending the individual's neck and rotating the head backwards in order to achieve alignment of the individual's oral, pharyngeal, and laryngeal axes. Typically, in normal sized individuals, that is an individual having a proper height to weight ratio, the alignment of the oral, pharyngeal, and laryngeal axes is aided by placing a standard pillow or small foam pillow under the individual's head and neck. Next, the individuals's mouth is opened and the laryngoscope is introduced into the mouth. Then, the individual's vocal cords are exposed allowing the endotracheal tube to be inserted through the exposed vocal cords. The tip of the endotracheal tube includes an inflatable collar that is inflated to create a seal on the inside of the trachea. The exterior end of the tube is connected to a breathing machine that sustains the individual's breathing while under the anesthesia.
Once the breathing tube is in place, a surgical procedure may be conducted on the anaesthetized individual. Following the surgical procedure, the individual is gradually brought out of the anesthesia. At that time, the breathing machine is disconnected, the endotracheal breathing tube is removed, and the individual begins breathing on his own.
It has been found, however, that performing an endotracheal intubation on an obese individual is more difficult. During the endotracheal intubation, the physician attempts to align the oral, pharyngeal and laryngeal axes so that the endotracheal tube can be visually guided into the proper position. At the same time, the physician mechanically assists the obese individual's breathing by physically moving air into the obese individual's lungs with a ventilation bag. When working with an obese individual positioned on a standard pillow, the physician is at a mechanical disadvantage due to the abdominal mass of the individual pressing upward against the individual's diaphragm. To ventilate the supine individual, the physician must exert enough force for the air pressure to move the individual's diaphragm against the weight of the individual's abdominal mass. In a normal sized individual, this mass may be easily displaced. In an obese individual, however, the large abdominal mass may be difficult for the physician to displace. Standard prior art pillows do not alleviate this problem.
Moreover, a similar problem occurs following the surgical procedure when the obese individual is brought out of anesthesia and must begin breathing on his own. The obese individual must breathe with enough force to displace his abdominal mass with his diagram. Since the individual is still somewhat anaesthetized, it may be difficult for attending personnel to get the individual to breathe with enough force. Standard pillows do not help with this problem.
The magnitude of the problem of managing the airways of obese individuals may be more fully appreciated in view of statistics that indicate that approximately 60% of adults in the United States today qualify as obese. Therefore, a need has arisen for an airway management apparatus that is capable of easing the breathing of obese individuals in the supine position. A need has also arisen for an airway management apparatus that aids in the alignment of the oral, pharyngeal and laryngeal axes in obese individuals.